Impotence or Erectile Dysfunction is a very common problem that affects 20 million (approximately 1 out of 5) American Men. Erectile dysfunction is the result of a single, or more commonly a combination of multiple factors. At one time impotence was thought to be the result of psychological problems but we now know that 90% of the cases are organic in nature. Some of the many causes of impotence include, diabetes, high blood pressure, heart and vascular disease, stress, hormone problems, pelvic surgery, trauma, venous leak, and side effects of frequently prescribed medications.
No
matter what the cause, most men have a secondary
psychological reaction that can worsen the situation.
Feelings of performance anxiety, guilt, and low
self-esteem are common. For many years impotence
was a problem that was not talked about because of its
personal nature. Men suffering from this
condition often do not know about the various
treatment options availible to them and do not seek
help.
TREATMENT
Treatment
options for erectile dysfunction can be divided into
four broad categories, pharmacological, mechanical,
surgical, and psychological.
Pharmacological
treatment involves delivering medication which can
help restore erections. There are several different
types of medication and ways of administering them.In
general, medical therapy is the most appealing form of
treatment and can be highly successful.
| |
|
|
|
| MEDICATION |
ROUTE |
MECHANISM |
EFFECTIVENESS |
| Yohimbine
(Yocon) |
Oral |
Alpha
receptor agonist |
Poor |
| Testosterone |
Injection,
Patch, Oral |
|
Good
(only in men with
low testosterone levels) |
| Prostaglandin
E1 (Caverject) |
Penile
injection |
Dilates
penile arteries |
Very
good |
| Papaverine/
regitine/ prostaglandin |
Penile
injection |
Dilates
penile arteries |
Very
good |
Prostaglandin
E1
(MUSE) |
Intraurethral
pellet |
Dilates
penile arteries |
Moderate |
| Sildenafil
(Viagra) |
Oral |
Increases
penile blood flow |
Research
data very good |
| Phentolamine |
Oral |
Increases
penile blood flow |
Research
only (at this time) |
Mechanical
treatment involves the use of a vacuum erection device
or "pump" along with a constriction ring.
The penis is placed in a vacuum tube and the air is
pumped out. This creates negative pressure and allows
blood to flow into the penis. Once the penis becomes
erect, a rubber ring is placed around the base of the
penis to prevent the blood from leaving. The vacuum
tube is then removed. This non-invasive mode of
therapy is effective in treating erectile problems
form most causes although the device can be cumbersome
to use.
Surgical
therapy is the most invasive form of treatment for
erectile dysfuction. The penile implant is a very good
option for those men who have failed medical therapy
or have a severe arterial or venous causes of
impotence. Penile microsurgical revascularization
procedures are reserved for those men who have a
discrete identifiable penile arterial blockage. This
surgery is technically challenging and must be
performed by an experienced microvascular surgeon. The
overall results are good in carefully selected
patients. Penile vein ligation surgery has met with
some controversy over its effectiveness but may yield
fair results in patients with a venous
leak.
| |
|
|
| SURGICAL PROCEDURE |
CAUSE OF DYSFUNCTION |
EFFECTIVENESS |
| Penile implant |
|
|
|
Semi-rigid
|
All |
Excellent penis always in semi-rigid state |
| Inflatable |
All |
Excellent penis looks more natural |
| Arterial Revascularization |
Discrete arterial blockage |
Moderate to good |
| Penile Vein Ligatation |
Discrete venous leak |
Poor to moderate |
Psychological
therapy is very useful in those cases of erectile
dysfunction which are a direct result of psychological
causes. These patients may also benefit from
pharmacologic or combination therapy.
The
treatment of erectile dysfunction is rapidly changing
as our understanding of erectile physiology expands.
Men are becoming increasingly aware of the many
different solutions availible for this problem and are
actively seeking help. Wives and partners are becoming
more involved in the treatment process. If you
or a loved one suffers from erectile dysfunction, help
is just a phone call away.
RELATED
WEBSITES ON IMPOTENCE:
Lifespring
Medical Group
Impotence
Center
Impotence
World Association
Impotence
Information Center
Dr.
Koop.Com
Health
Answers: Impotence
Impotence
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